Present and future of PET-radiopharmaceuticals

Abstract

The use of Positron Emission Tomography (PET) is increasing
dramatically worldwide. To further apply the unique properties
of PET, more clinically validated PET-radiopharmaceuticals are
required. To increase the availability of more PET-radiopharmaceuticals
on one hand new and better radiochemical preparation
methods are being developed and on the other hand legislation
with respect to the production of PET-radiopharmaceuticals
should be appropriate.
With respect to radiochemistry development, most efforts
have been made on the use of 11C and 18F as radionuclides.
11C-radiochemistry mainly relies on 11C-methylation reactions,
but recently simple and reliable 11C-radiochemistry based on
11C-carbon monoxide has become available.
Recent developments in the production of 18F-radiopharmaceuticals
are focused on synthesis methods that are simple to perform
and therefore enabling easy dissemination. Click chemistry, chelation
of 18F and new catalytic systems are being developed.
Also developments in labeling methods with 68Ga, 89Zr and 64Cu
will stimulate the use of these radiometals for clinical use.
Application of PET-radiopharmaceuticals for use in patients is
subject to strict legislation. The guidelines with respect to Good
Manufacturing Practice (GMP) however pose severe constraints
to small scale radiopharmacies in hospitals. Currently there is
a debate to adapt GMP-regulations for specific production of
PET-radiopharmaceuticals intending to maintain the required
quality aspects but not to hamper innovation and further development
of PET.